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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVlCES <br /> 3200 CEDAR STREET, EVEREl7, WA98201 C _ �/-D� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org � <br /> �oq �6 _o� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> l ,- �� " � i r !�.'�� <br /> PROJ�CT ADDRESS <br /> �.j . � " �:�i i � ... / ' " ,%t,. _ i p' � ,- �.. . . <br /> Owner Mail Addross City State/Zip Phone <br /> Tenanl Mail Address Cily Stale/Zip Phone <br /> - � ,�..�_ ��� �A�.�yS� � L4. C„ /- . irl��� ' -i � c- . � <br /> [Iedrical�Conlraclor htailAddress Cily Stale/Zip Phone <br /> L � �7 U_. � <br /> Slale Lir.c�nse Number� Conlrad Price ol Work <br /> "� ` � �'.:.i:c i � ':., � . - �� .�„ — <br /> :� <br /> Proposed Use o�Buildin� � Conlacl Person (Plan Revicw) <br /> Descriplion of Work lo Oe Done: '�!� , '_r ���✓ ,a� 1,:12(„��A •i : .+: .:-�,�-' �,., , «r <br /> . l�' '�.- :: !_ ,� rr�c_.S c. <br /> I <br /> NOTE: WIRING IN NON-DWELLING� IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ���C� <br /> I hereby certily fhat 1 have rcad and examined fhis applicatiun a�nd kno�v the sarne fo be frue and �C�� <br /> corrocL All provisions o(laws and qrelinances governmc�tlus t}�pe o/n•ork n�ilf be cornplefed <br /> �rhe(her spealicd herein or noL Thc granfin�e(a perrrnl does nol resunte to give aufhority to <br /> ��iolate or cancel(he provisions o/any other state or local la�r reguPfing consfrucfion or fhe <br /> pedormance o!construction. That 1 am nufhonzed Gy fhe on�ner ol lhis property to per(unn Ihe <br /> �ro�k/ur wNich applicafion is made and I comply with fhe Sfate Confracfors Law 18.27 RCW and <br /> 79�.200 WAC. <br /> � � .. . . � � i , <br /> Siyna�me Da�a <br />